| Name: | Sparks HealthCare Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Nov 2021 (3 years ago) |
| Entity Number: | 000-954-703 |
| Register Number: | 000954703 |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 3503 D NORTH MEMORIAL PARKWAYHUNTSVILLE, AL 35810 |
| Registered Office Street Address ZIP Code: | 35810 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396498853 | 2022-02-03 | 2022-05-26 | 3503 MEMORIAL PKWY NW STE D, HUNTSVILLE, AL, 358102445, US | 3503 MEMORIAL PKWY NW STE D, HUNTSVILLE, AL, 358102445, US | |||||||||||||||||||||||||
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| Phone | +1 205-442-6541 |
Authorized person
| Name | MARY E SPARKS |
| Role | CRNP/OWNER |
| Phone | 2054426541 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LA2100X - Acute Care Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | Yes |
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| Is Primary | No |
| Name | Role |
|---|---|
| Sparks, Mary E | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
